Recurrent Conjunctival Nodule Followed by Spontaneous Extrusion of Onchocerca lupi : A Rare Zoonotic Filarial Infection

Onchocerca lupi is a zoonotic nematode primarily affecting dogs, rarely causing human ocular infections. This report presents a rare case of human ocular O. lupi infection from Türkiye with a distinct clinical feature. A 19-year-old woman presented with a 2-week history of redness in her right eye. Examination revealed a subconjunctival nodule in the superotemporal quadrant. Orbital MRI showed a heterogeneous hypointense lesion in the right upper eyelid. Following an excisional biopsy and topical treatment, symptoms partially regressed, and the patient was monitored. One year later, she returned with recurrent hyperemia and mucopurulent discharge. During a conjunctival swab collection, a subconjunctival nematode was observed and extracted. Microscopic analysis confirmed adult O. lupi morphology, showing a multilayered cuticle with undulating annular ridges. This case contributes valuable insights into the literature regarding recurrent nodular presentation and delayed spontaneous extrusion.